| Ms Shelly Marie Green, CRNA | |
|
707 Sheridan Ave, Cody, WY 82414-3409 | |
| (307) 587-2139 | |
| Not Available |
| Full Name | Ms Shelly Marie Green |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 707 Sheridan Ave, Cody, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205176476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 146502 (Kansas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 35180-1385 (Wyoming) | Primary |
| Entity Name | Wyoming Perioperative Anesthesia Consultants Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508119439 PECOS PAC ID: 0840433132 Enrollment ID: O20130905000971 |
| Entity Name | Northern Wyoming Surgical Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740027812 PECOS PAC ID: 9931630837 Enrollment ID: O20241002003303 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Shelly Marie Green, CRNA Po Box 1155, Billings, MT 59103-1155 Ph: () - | Ms Shelly Marie Green, CRNA 707 Sheridan Ave, Cody, WY 82414-3409 Ph: (307) 587-2139 |
Brent Adam Mcallister, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 707 Sheridan Ave, Cody, WY 82414 Phone: 307-527-7501 | |
Shannon Vance, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 707 Sheridan Ave, Cody, WY 82414 Phone: 307-587-2139 | |
Sandra E Whalen, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 732 Lindsay Ln, Cody, WY 82414 Phone: 307-587-2139 | |
Barton E Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 732 Lindsay Ln, Cody, WY 82414 Phone: 307-578-1860 Fax: 307-587-2364 |